Objectives: Our goal is to show that nanofat grafting, Rigenera micrograft, and PRP can be effective in hair rejuvenation. This presentation aims to present techniques, analyzing effectiveness, and complications.

Introduction: Hair are very important to men and women. Hair are an element of seduction, a symbol of strength and power. A lot of religions ask to hide them. Hair are also related to a lot of expressions.Losing one's hair would have a direct impact on self-esteem, confirms the latest studies. 62% of men say they are
less sure of themselves than those who have a lot of hair

Materials / method: 12 Patients presenting androgenic alopecia were included.
After abdominal fat harvesting (or inner face of the knees, or thighs) and fat graft preparation, nanofat grafting was performed in the scalp (4 patients). After punch biopsy and cutting of scale tissue, disaggregation by Rigeneracon was done (4 patients), and injections performed in the scalp. For PRP after taking blood and centrifugation, PRP was injected in the dermis of the scalp (4 patients).
Images before and after were taken.

Results: A significative improvement was found for all patients: images showed new hair growth, a
faster telogen-anagen transition, an increase hair density, the growth of thicker hairs and reduction inflammatory component
No complications were found.

Conclusion: Regenerative medicine seems to be effective in hair loss. Those autologous procedures are able to provide a very good rejuvenation.
We now need studies to compare nanofat, Rigenera micrograft, and PRP.
We founded a group to do a multicenter study randomized and publish our results on more than 100 patients.

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Objectives: PRP and stem cells for Alopecia - find what is the evidence in clinical practice.

Introduction: A stem cell (SC) is an undifferentiated cell with potential to develop into different types of cells. After division it may remain a stem cell or become another type.
We will consider 4 SC therapy modalities:
-Signal stimulation: we add growth factors (GF) that will stimulate SCs.
-SC injection after isolation.
-HF division (SC will originate 2 follicles from 1)
-SC injection after isolation and multiplication

Materials / method: We checked PubMed for finding what is the evidence for the use of each modality in clinical practice. We also share our own experience with some of them.

Results: 1. Signal stimulation: Patients with AGA treated with autologous PRP show slight improvements in clinical photo, hair count and hair thickness. 2. SC injection after isolation: SC from scalp, liposuction, bone-marrow aspiration or Warton jelly. Improvements of around 15% in hair count. 3. HF division: This method is based in the believe that an extracted partial longitudinal follicular unit can regenerate completely differentiated hair in both donor and receptor region - no evidence. 4. Culture-expanded stem cells obtained from scalp - Good results in murine models but not in human by now.

Conclusion: Modalities 1 and 2 are valid but only slight improvements are obtained. Modality 3 - no evidence by now that is feasible. The advances in molecular biology may turn modality 4 very useful in the future, allowing to obtain unlimited number of hair follicles from a single scalp biopsy, but by now it was not possible to reproduce in human the good results in murine models.

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Objectives: To showcase the treatment approach of combining Platelet Rich Plasma, Fat Cells and Adipose-derived Stromal Cells to promote hair growth

Introduction: Hair loss, especially androgenic alopecia (AGA) in women and men of all ages and ethnicities is a majorly widespread problem with tendency to increase in age. Many of those patients experience decreased quality of life and feel self-conscious. Medication and vitamins/supplements or similar administered topically, orally and by injection can promote hair growth although some of them can have adverse effects which limits their use.
Innovative treatment approaches currently studied for hair restauration are own-cell-based therapies, aiming for stimulating existing follicles.

Materials / method: Biologic factors such as signaling from stem cells, dermal papilla cells and platelet-rich plasma are some of the current therapeutic agents being studied for hair restoration with milder side effects. There is a close correlation between subcutaneous adipose tissue and hair follicle formation as adipocyte lineage cells in different stages expose different functions involved in the development e.g. hair follicles: Various cytokines secreted by adipose-derived stem cells are known to stimulate dermal papilla cells (DPCs) for hair growth.

Results: Stromal Vascular Fraction (SVF) can be harvested from the autologous adipose tissue of the respected patient, ideally mixed with the patient`s own Platelet Rich Plasma (PRP) as the added growth factors do build an ideal scaffold for those stem cells and cause a homing phenomenon. The respective fat cells are known to build the ideal scaffold to host such cells.
The treatment is performed as a once-only-treatment by injections to the scalp, namely to the dermal papilla cells (DPCs). An increase in anagen hair density can be observed by the earliest 12 weeks after this treatment.

Conclusion: Our preliminary results confirm the known effects of resulting in regulating and boosting hair growth. But most of the mechanisms in hair restoration exerted by the described biologic factors are still being researched. As for now, standardized protocols don`t exist yet and further studies are needed to support efficacy and evidence of this auspicious, innovative treatment approach for hair regeneration.

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